2017/18 Tax Benefits Application For Homeowners - New York City Department Of Finance
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52017/18
new YorK citY DePArtMent oF FinAnce
ProPertY Division
TAX BENEFITS APPLICATION FOR HOMEOWNERS
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TM
Department of Finance
This application is for your eligible New York City primary residence. Please read the instructions before you fill it out.
If you have questions, contact 311 or visit nyc.gov/contactfinance.
Applications with all required documents must be postmarked by March 15, 2017.
Please submit all required documents. Failure to do so will delay processing or result in denial.
(if the deadline falls on a weekend or national holiday, the application must be
postmarked by the following business day to be eligible for the 2017/18 tax year)
Please check the box of each exemption you are requesting:
senior
Disabled
veteran
clergy
q
q
q
q
Sections 1, 2, 3, 4, 5, 6, 10
Sections 1, 2, 3, 4, 7, 10
Sections 1, 2, 3, 8, 10
Sections 1, 2, 3, 9, 10
SECTION 1 - PROPERTY INFORMATION
____________
____________________________________________________________
_______________
/
HOUSE NUMBER
STREET NAME
APARTMENT
UNIT
____________
Borough/Block/Lot:
’
nyc.gov/bbl
zIP CODE
YOUR PROPERTY
S BLOCK AND LOT CAN BE FOUND AT
Date you purchased the property
:
MM
DD
YYYY
Type of Property:
1-, 2-, 3-family dwelling
4+ family dwelling and the percent of space used for primary residence:________%
n
n
condominium unit
cooperative - Number of shares for your unit: ___________
n
n
Coop Management Company: ___________________________________________ Phone # ___________________
CONTACT NAME
COMPANY
Yes
no
Is any portion of the property used for other purposes (commercial, professional office, etc.)?
n
n
If YES: Percentage of space used for other purposes:___________________%
SECTION 2 - OWNER INFORMATION
if there are more than two owners, please complete the Additional owners information and certification section of the application.
owner #1: ___________________________ ___________________________ Date of Birth:
FIRST NAME
LAST NAME
MM
DD
YYYY
Yes
no
Social Security #:
Is this Owner #1’s Primary Residence?
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n
owner #2: ___________________________ ___________________________ Date of Birth:
FIRST NAME
LAST NAME
MM
DD
YYYY
Yes
no
Social Security #:
Is this Owner #2’s Primary Residence?
n
n
If any owner does not use the property as their primary residence, please answer the following questions.
Yes
no
Is an owner receiving medical care as an in-patient at a residential health care facility?
n
n
Yes
no
Is an owner absent from the residence due to other residency?
n
n
Yes
no
Is an owner absent from the residence due to divorce, legal separation or abandonment?
n
n
If YES to any of the above, please provide the absent owner’s name:__________________________________________
HB-01 Rev 5.18.2016
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